Zdorovʹe Rebenka (Nov 2020)
Hemostasis in premature newborns with congenital pneumonia in the neonatal period
Abstract
Background. Intraventricular hemorrhages predominate among the causes of high mortality in premature newborns. The purpose of the study was to identify the features of clinical manifestations of hemostasis disorders and coagulogram indicators in premature newborns with congenital pneumonia and varying body weight in the neonatal period. Materials and methods. Depending on the gestational age and body weight, the hemostatic system and clinical manifestations of hemorrhagic disorders were examined in 227 newborns. The study was designed as a prospective clinical trial. Results. In preterm infants of all groups, compared with the control group, hypocoagulation in all phases of blood clotting and increased fibrinolysis were registered in the first week of life, with an increase in the severity of disorders as the gestational age, body weight, and infectious pathology were reduced. By the end of the neonatal period, premature infants with low body weight and congenital pneumonia showed hypocoagulation in the second and third phases of blood clotting, infants with very low and extremely low body weight and congenital pneumonia maintained hypocoagulation in all phases of blood clotting and increased fibrinolysis. The proportion of intraventricular hemorrhages in premature newborns of both study groups was statistically significantly high (OR = 5.69 (4.15–7.80), OR = 23.91 (16.81–34.00)) than in the group of apparently healthy premature infants, and the frequency of intraventricular hemorrhages grade III–IV in premature newborns with very low and extremely low body weight and congenital pneumonia was statistically significantly higher (OR = 5.24 (3.79–7.24)) than in infants with low body weight and congenital pneumonia. Conclusions. The above points out the need for hemostasis control and preventive antihemorrhagic therapy in premature newborns with congenital pneumonia during the neonatal period.
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